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Octogenarians fare well after aortic valve replacements

Research Activities, March 2010, No. 355

Severe aortic stenosis occurs when the heart's aortic valve narrows and obstructs blood flow, causing the heart to work harder to pump blood. This extra work weakens the heart, further limiting the amount of blood it can pump. Fortunately, a surgery that replaces the aortic valve can extend the lives of those who suffer from aortic stenosis. Even people in their 80s who undergo aortic valve replacement (AVR) surgery have life expectancies similar to their elderly counterparts, according to a new study.

Donald S. Likosky, Ph.D., of Dartmouth-Hitchcock Medical Center, and colleagues studied 7,584 patients who had AVRs from 1987 to 2006. They found that more than half of the patients were alive 6 years after the surgery, mirroring the life expectancy of the general population. In fact, survival rates were 6.8 years for patients who were 80 to 84 and 6.2 years for patients who were 85 and older.

Octogenarians who had both AVR and coronary artery bypass graft (CABG) surgeries had similar long-term survival rates, with patients aged 80 to 84 living an additional 6.8 years and patients older than 85 living an average of 7.1 years. However, patients who underwent AVR and CABG had higher 30-day mortality rates than patients who had AVR only (6.2 vs. 3.7 percent for patients younger than 80, 9.4 vs. 6.7 percent for patients aged 80 to 84, but 8.5 vs. 11.7 percent for patients 85 and older).

As the number of octogenarians in the United States grows, so will the number of AVRs for elderly patients. These findings demonstrate that AVRs are an effective way to safely extend these patients' lives. This study was funded in part by the Agency for Healthcare Research and Quality (HS15663).